This Article Full Text Full Text (PDF) All Versions of this Article: 113/19/2285    most recent CIRCULATIONAHA.105.590463v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Gerber, Y. Articles by Roger, V. L. Search for Related Content PubMed PubMed Citation Articles by Gerber, Y. Articles by Roger, V. L. Related Collections Epidemiology Primary prevention Secondary prevention Related Article

(Circulation. 2006;113:2285-2292.)
© 2006 American Heart Association, Inc.

Epidemiology

Secular Trends in Deaths From Cardiovascular Diseases

A 25-Year Community Study

Yariv Gerber, PhD; Steven J. Jacobsen, MD, PhD; Robert L. Frye, MD; Susan A. Weston, MS; Jill M. Killian, BS; Véronique L. Roger, MD, MPH

From the Division of Cardiovascular Diseases (Y.G., R.L.F., V.L.R.) and Department of Health Sciences Research (Y.G., S.J.J., S.A.W., J.M.K., V.L.R.), Mayo Clinic College of Medicine, Rochester, Minn.

Correspondence to Dr Véronique L. Roger, Division of Cardiovascular Diseases, Mayo Clinic, 200 First St SW, Rochester, MN 55905. E-mail roger.veronique{at}mayo.edu

Received September 22, 2005; revision received March 15, 2006; accepted March 21, 2006.

Background— Although age-adjusted cardiovascular disease (CVD) mortality has declined over the past decades, controversies remain about whether this trend was similar across locations of death and disease categories and about the existence of age and sex disparities.

Methods and Results— We examined CVD mortality trends in Olmsted County, Minnesota, between 1979 and 2003 using the categories defined by the American Heart Association, including coronary heart disease (CHD), non-CHD diseases of the heart, and noncardiac circulatory diseases. Data on demographics, cause, and location of death of all 6378 residents who died of CVD were analyzed. Although decreases in the age-adjusted rates occurred in all groups, the magnitude of the decline varied widely. Lesser annual declines were noted in out-of-hospital than in-hospital deaths (1.8% versus 4.8%; P<0.001), in older than in younger persons (1.5% at age 85 years versus 3.9% for those 74 years of age; P<0.001), and in women relative to men (2.5% versus 3.3%; P=0.007). Furthermore, although CHD showed a marked annual decrease (3.3%), more modest decrements were found for non-CHD diseases of the heart (2.1%) and noncardiac circulatory diseases (2.4%) (P=0.02 and P=0.04 for the comparison with CHD decline, respectively).

Conclusions— Over the past 25 years, CVD mortality declined markedly in the community, but there were large disparities in the magnitude of the decline, resulting in a shift in the distribution toward out-of-hospital and non-CHD deaths. Further reduction in CVD mortality will require strategies directed at elderly persons and women, in whom out-of-hospital rates have improved only minimally.

---

 

CLINICAL PERSPECTIVE

Related Article:

Issue Highlights
Circulation 2006 113: 2261. [Full Text]

This article has been cited by other articles:

				R. Auer, J. Gaume, N. Rodondi, J. Cornuz, and W. A. Ghali Efficacy of In-Hospital Multidimensional Interventions of Secondary Prevention After Acute Coronary Syndrome: A Systematic Review and Meta-Analysis Circulation, June 17, 2008; 117(24): 3109 - 3117. [Abstract] [Full Text] [PDF]

				P. N. Nemetz, V. L. Roger, J. E. Ransom, K. R. Bailey, W. D. Edwards, and C. L. Leibson Recent Trends in the Prevalence of Coronary Disease: A Population-Based Autopsy Study of Nonnatural Deaths Arch Intern Med, February 11, 2008; 168(3): 264 - 270. [Abstract] [Full Text] [PDF]

				H. M. Krumholz and F. A. Masoudi The Year in Epidemiology, Health Services Research, and Outcomes Research J. Am. Coll. Cardiol., December 4, 2007; 50(23): 2254 - 2262. [Full Text] [PDF]

				Y. Gerber, C. S. Rihal, T. M. Sundt III, J. M. Killian, S. A. Weston, T. M. Therneau, and V. L. Roger Coronary Revascularization in the Community: A Population-Based Study, 1990 to 2004 J. Am. Coll. Cardiol., September 25, 2007; 50(13): 1223 - 1229. [Abstract] [Full Text] [PDF]

				L. Spaggiari, G. Veronesi, M. Bellomi, and P. Maisonneuve Computed Tomography Screening for Lung Cancer JAMA, August 1, 2007; 298(5): 514 - 514. [Full Text] [PDF]

				Y. Gerber, S. J. Jacobsen, J. M. Killian, S. A. Weston, and V. L. Roger Seasonality and Daily Weather Conditions in Relation to Myocardial Infarction and Sudden Cardiac Death in Olmsted County, Minnesota, 1979 to 2002 J. Am. Coll. Cardiol., July 18, 2006; 48(2): 287 - 292. [Abstract] [Full Text] [PDF]